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Trinity Extended Day Handbook: Extended Day Program Agreement

Extended Day Program Agreement

REGISTRATION

Please submit this form before your child attends the Extended Day program.

I hereby request supervision for my child, and agree to the following terms and conditions:

  1. It is understood that I am financially responsible for the service fee for my child(ren) for the months of usage and the programs attended, and I will pay the monthly fee, billed by the Business Office.

  2. Adherence to the Honor Code will be required of all TED participants; behavioral contracts will be required if warranted.
  3. For those beginning the program in mid-month, prorated fees will be applied.

  4. It is understood that a notice of discontinuance of use by any child at any time must be submitted in writing to the TED director, including the date of discontinuance. Prepaid fees will be refunded only for all full months of service not used.

  5. Please contact the TED director concerning any changes in your child’s daily or monthly schedule as contracted. The number of days contracted on a weekly basis must be used within the week and not be carried over to another week.

  6. For drop-in services, you will have to fill out a drop-in form and return it to the TED director, then be billed the daily rate from the Business Office.

REGISTRATION FOR SPECIAL DAYS

RATES

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ENROLLMENT INFORMATION

Student’s name   Grade
Address     
City State  Zip Code
Parent’s Name    
Home Phone Business Phone Cell Phone
Parent’s Name    
Teacher’s name    

Please list the names of the person(s) allowed to pick up your child. If this list changes throughout the year, please inform TED in writing. Include phone number and relationship information. ____________________________________________________________________________________________________________________________________________________________________________________________________

Please check all that apply. Please do not enclose a check with this agreement. All TED billing will be done through the Business Office.

Days

____ Monday ____ Tuesday ____ Wednesday ____ Thursday ____ Friday ____5 Days Per Week

Dismissal Time

_____ 5pm or _____ 6pm

 

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